Kidney Failure Overview
Kidney failure (end-stage renal disease) is the result of other serious health problems that have caused permanent harm (damage) to the kidneys over time. Once the kidneys are damaged, they can no longer function normally. If the disease continues to progress, the kidneys lose their capacity to perform completely, causing chronic kidney disease.
Kidneys are essential organs that filter bloodstream waste products. In addition, they assist in regulating blood pressure, help in the production of red blood cells, and maintain electrolyte balance in the body. A failure of kidney function means the organs no longer function well enough for the patient to survive without a kidney transplant or ongoing dialysis.
Not every type of kidney failure is permanent. This is because with effective treatment the kidneys may return to normal function or almost normal function if the patient is not suffering other serious health issues. That said, having an associated health issue known to cause kidney failure does not definitely mean the patient will develop the condition. With medical attention and living a healthy lifestyle, the patient can control these health issues to ensure that the kidneys function for as long as possible.
What Causes Kidney Failure?
There are many conditions in the body that can cause permanent damage to the kidneys to decrease their functionality and their ability to filter out waste products completely. Diabetes is the major cause of end-stage renal disease followed by high blood pressure. However, there are other serious medical conditions that could affect the kidneys and caused them to fail. These include:
- Urinary tract problems
- Nephrotic syndrome where too much protein remains in the urine
- Genetic conditions including polycystic kidney disease
- Autoimmune diseases including lupus and IgA nephropathy
- Heart attacks
- Heart disease
- Allergic reaction
- Liver failure
- A severe burn
- A severe infection including sepsis
- Kidney related blood clots
- Hemolytic Uremic Syndrome where bacterial infections break down red blood cells in the intestines
- Lupus that causes body organ inflammation
- Chemotherapy treatments
- Specific antibiotics
- Alcohol or drug abuse
- Toxic heavy metal overload
- Thrombotic thrombocytopenic purpura that causes small vessel blood clots
- Glomerulonephritis that causes small blood vessel inflammation in the kidneys
- Multiple myelomas – cancer of bone marrow
- Image testing dyes
- Vasculitis – blood vessel inflammation
A complete failure to kidney organs can occur within two days. This acute kidney injury can occur concomitantly with other events including heart attacks, urinary tract problems, insufficient blood flow to the kidneys, drug abuse, illegal drug use, and heart attacks. Blood pressure medications and anti-inflammatory drugs can also limit the amount of blood flow to the kidneys, and cause the kidneys to malfunction.Urination Problems
If the body is unable to eliminate urine, it can build up toxins that overload one or both kidneys. Additionally, cancerous tissue and tumors can block urine passageways. These cancers include colon, prostate, bladder, and cervical conditions.
Other serious medical conditions can interfere with the ability to urinate in over time lead to chronic kidney disease and ultimately kidney failure. These conditions involve:
- Kidney stones
- Urinary tract blood clots
- Enlarged prostate
- Damage to bladder control nerves
Common Symptoms and Complications
The kidneys perform many functions to ensure that the body remains healthy. This includes cleaning the bloodstream of waste products, controlling fluids and chemicals in the body, and regulating the body’s blood pressure levels while making red blood cells. Unfortunately, necessary dialysis treatments typically only filter out the waste product when the kidneys are no longer able to perform the function alone and do not control chemicals and fluids in the body, make red blood cells or maintain blood pressure levels.
Kidney failure is usually a result of chronic kidney disease that can become progressively worse over time. In many cases, the symptoms do not reveal themselves until the kidneys have been severely damaged. In the later stages of chronic kidney disease, at the point where the kidneys are almost failing, the patient will often notice symptoms including excess fluid buildup in the body. Many of the common kidney failure symptoms indicating that the organs are not functioning properly include:
- Itching sensation
- Difficulty in sleeping
- Swollen ankles and feet
- Loss of appetite
- Vomiting and nausea
- Muscle cramps
- Difficulty in catching a breath
- Excessive or minimal (too much or too little) urine production
- Abnormal urine and blood tests
- Anemia (low red blood cell count)
- Unexpected weight loss
- Easy bruising
- A metal taste on the tongue
- Muscle cramps and twitches
- Tingling and numbness sensations
- Chest pains
When acute kidney failure occurs, the patient often notices at least one of the following symptoms:
- Vomiting and fever
- Back pain
- Belly (abdominal) pain
Any one of the symptoms listed above may be an indicator that the patient is suffering serious kidney problems that require immediate medical attention.
Diagnosing Kidney Failure
To verify kidney failure has occurred, doctors will often perform a creatinine level blood test to determine if the kidneys are functioning normally. This is because normal kidney function removes access creatinine from blood to be eliminated through urination. Higher levels of creatinine in the bloodstream are using indicated that the organs are not functioning properly and cleaning blood as required. The test works well as an early indicator that kidney problems are leading to kidney failure, which can happen months or years before the patient feels sick from their condition.
A chemistry screen will also be performed to check the levels of calcium, potassium, and sodium in the bloodstream. The doctor may recommend the patient undergo an ultrasound to capture an image of the kidneys for further evaluation.
Treating Kidney Failure
When the kidneys begin to fail or work abnormally, the doctor will usually refer the patient to a nephrologist (kidney specialist) who will develop an effective treatment plan to minimize symptoms and stop the progressive condition if possible. The doctor may recommend various treatments including:
- Dialysis – This procedure treats kidney failure by removing or filtering waste products from the bloodstream. Based on the condition of the patient and their preferences, the nephrologist might recommend one of two different dialysis procedures that include:
- Hemodialysis – Using a synthetic dialyzer membrane, the equipment filters out waste products and removes extra fluid levels from the bloodstream. This procedure is typically performed in a hospital, medical center, or outpatient dialysis facility at least three times every week. Some patients undergo hemodialysis in their home environment.
- Peritoneal Dialysis – The technician uses the peritoneal membrane (the lining of the abdomen) and dialysate (solution) to remove accumulated waste products and extra fluid levels from the bloodstream. Typically, this treatment is performed in a home environment for a few hours every night or during day sessions.
- Infection Treatments – The doctor may recommend using antibiotics to prevent other problems including infections. Medications are also available to rid the body of built-up fluids to ensure minerals stay in balance.
To be effective, the patient must take the medication as directed by their doctor. Additionally, the doctor may recommend the patient follow a strict special diet to ensure the kidneys work as little as necessary. The diet will likely limit the intake of high levels of phosphorus, potassium, and sodium (salt).